Laserfiche WebLink
EVERETT <br />WASHINGTON <br />PERMIT APPLICATION <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 1 FAX 425-257-8857 1(E) everetteps@everettwa.gov I www.everettwa.gov/permits <br />Nuu or Black Ink Only Please PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 2301 Colby Avenue <br />I PROPERTY TAX #: 00439149000100 <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Land: Stoyan Mitrachikov; Power Pole: SnoPUD TENANT BUSINESS NAME (Commercial): T-Mobile (Applicant) <br />OWNER MAILING ADDRESS: STREET 2301 Colby Ave, #5 <br />CITY Everett STATE WA zip 98201 <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAME: S <br />L <br />CONTRACTOR ADDRESS: STREET <br />CITY STATE ZIP <br />CONTRACTOR PHONE: <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 4 1 <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR El OTHER (Please Specify) _Authorized Rep for T-Mobile (Applicant) <br />CONTACT NAME: <br />John Eder, J4 Site Solutions, Inc. <br />CONTACT PHONE: 253-278-2902 <br />CONTACT EMAIL: John@j4sitesolutions.com <br />BUILDING INFORMATION <br />Existing Use of.Building: SnoPUD distribution pole; multi -family 4-plex <br />Contract Price of Work: $ 25 000.00 <br />Proposed Use of Building: No change - eixsitng wireless comm facility lHeat <br />Source: OGas ❑Electric []Other <br />BUILDING USE: [3SFR ❑Townhouse ❑Du lex ❑ADU ©Multi -Family- # Units: ©Commercial DAccessory Structure <br />Type of Project: ❑New ❑Addition CZIRemodel ❑Re air ❑T.I. ❑Sin ❑S rinkler ❑Demolition []Change of Use <br />DESCRIPTION OF WORK: On ex. utility pole, remove (3) antennastmounts and replace with (6) antennas on new mounts, remove <br />(12) diplexers, replace (3) WAS, remove (1) surge protector, remove (5) RRU and replace with (6) RRU, replace (2) cables. <br />In the interior equip. room, replace (1) chair rack w/ (1) 23" rack, remvoe/replace/add ancillary wall and rack -mounted equip. <br />ASSOCIATED BUILDING PERMIT # if applicable): <br />MECHANICAL; PERMIT APPLICATION <br />- <br />PLUMBING PERMIT <br />APPLICATION <br />Fixture <br />count <br />List of Fixtures <br />FbMra <br />count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />A/C — Air Handling Units <br />Gas Piping <br />Backflow Preventer (Inside Bldg) <br />Shower, Tub, or Combo <br />Boiler <br />Gas Range <br />Clothes Washer <br />Sink -Commercial (3-com ,pr ,floor) <br />Clothes Dryer <br />Heat Pump&Ductless <br />Dishwasher <br />Sink -Residential (kitchen,bath,bar) <br />Duct System (Remodel) <br />Refrigeration <br />Drinking Fountain <br />Sink -Utility, laundry, mop <br />Exhaust Fans (Residential) <br />Commercial Ventilatior <br />(Not HeaVAC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Ty 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type II) <br />Water Heater <br />Interceptor -Grease <br />WasteMater Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />Water Service (behind meter) <br />Forced Air Systems <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplacellnsert/Log <br />I <br />Roof Drains <br />Water Heater <br />SPRINKLER / SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />ater Suppression System <br />I <br />lNo. -of Heads <br />Chemical Suppression System <br />I <br />INo. of Heads <br />ACKNOWLEDGEMENT: I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br />current federal, state, and local law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing from the <br />Building Official before being authorized under any circumstance. I am the owner, or I am authorized by the owner of this property to perform the work for which application is made, <br />and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />PEi <br />John Eder a"�"" ��« ��-� August 21, 2020 TO <br />OwneriAuthorized Agent Signature Date (Revised 10/10/2018) <br />John Eder, J4 Site Solutions, Inc, as Authorized Representative of T-Mobile. YZ— <br />